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NPI Code Detail

MEDICARE: LONDON CARE, LLC

MEDICARE: LONDON CARE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053483768
Entity Type Code : Organization
Provider Name (Legal Business Name) : LONDON CARE, LLC
Provider Business Mailing Address
First Line : 111 W MICHIGAN ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53203-2903
Country : US
Telephone Number : 414-908-8119
Fax Number : 414-908-7105
Provider Business Practice Location Address
First Line : 218 ELM ST
Second Line :
City : LONDON
State : OH
Zip : 43140-2130
Country : US
Telephone Number : 740-852-3100
Fax Number : 740-852-7266
Authorized Official
Title or Position : DIRECTOR OF COMPLIANCE
Name : DONNA JO MAASSEN
Credential :
Telephone Number : 414-908-8119
Provider Enumeration Date : 11/15/2006
Last Update Date : 03/29/2008

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Practice Location Address:
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1649476458 — MRS. COLLEEN DENISE WOLFORD P.T.
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1528265915 — MRS. RENA L. CALL PT
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1992903678 — JULIE A DAVIS OTR-L
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Directions to “LONDON CARE, LLC ” Practice Location

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